Elango Santhosh Kumar, P Saravanan M, Jayaraman Harini, Viswan Santhosh, A Ebrahim Fathima Hajira E
Department of Biochemistry, Karpaga Vinayaga Institute of Medical Sciences and Research Centre, Chengalpattu, Tamil Nadu, India.
Asian J Neurosurg. 2025 May 7;20(3):523-528. doi: 10.1055/s-0045-1808246. eCollection 2025 Sep.
Traumatic head injury, which has a high mortality rate, can present as mild contusions, hemorrhages (subdural, extradural, intraparenchymal), diffuse axonal injuries, or direct penetrating injuries. Glasgow Coma Scale (GCS) is used to assess the severity of head injury. Stress-induced hyperglycemia associated with traumatic brain injury has high mortality compared with hyperglycemia in diabetic patients. Stress-induced hyperglycemia not only occurs due to head injury but also serves as a predictor of its outcome. C-reactive protein (CRP) levels are also associated with severity of head injury. Triglyceride levels are said to correlate with neuroinflammation and apoptosis, thus pivotal with severity of traumatic brain injury. With this background, this study aims to compare the levels of blood glucose, CRP, and serum triglycerides in patients with traumatic head injury according to their level of consciousness.
This article compares the levels of blood glucose, CRP, and serum triglyceride in traumatic head injury patients according to their GCS and assesses their trends.
Patients were divided into two groups (patients with GCS ≤ 8 as group 1 and patients with GCS > 8 as group 2). Blood was collected in these patients at admission, 24 hours after admission, and 48 hours after admission. Glucose was estimated at admission, 24 hours, and 48 hours after admission. CRP and triglycerides were estimated after 24 and 48 hours after admission. The levels were compared between groups and also their trends were assessed.
Mean and standard deviation were calculated for the above parameters using Excel. Statistical analysis was done using SPSS software version 26. Statistical significance was assessed using " -test" and "analysis of variance." A -value of < 0.05 was considered statistically significant.
Group 1 showed increased levels of glucose after 24 and 48 hours compared with group 2. CRP showed increased levels in group 1 compared with group 2. There was no significant difference in triglyceride levels between the two groups. Levels of blood glucose showed decreasing trends in group 2. CRP showed increasing trend in group 1. Triglyceride levels showed increasing trend in both the groups.
The decreasing trend in glucose levels in group 2 and increasing trend in CRP levels in group 1 are due to the same pathogenesis, which is associated with the severity of head injury. Increased trends in triglyceride levels were seen in both the groups. Since the association of levels of these parameters and their trends with severity of head injury, regular and serial monitoring of these analytes may be used as prognostic marker.
创伤性颅脑损伤死亡率高，可表现为轻度挫伤、出血（硬膜下、硬膜外、脑实质内）、弥漫性轴索损伤或直接穿透伤。格拉斯哥昏迷量表（GCS）用于评估颅脑损伤的严重程度。与糖尿病患者的高血糖相比，创伤性脑损伤相关的应激性高血糖死亡率更高。应激性高血糖不仅因颅脑损伤而发生，还可作为其预后的预测指标。C反应蛋白（CRP）水平也与颅脑损伤的严重程度相关。据说甘油三酯水平与神经炎症和细胞凋亡相关，因此对创伤性脑损伤的严重程度至关重要。在此背景下，本研究旨在根据意识水平比较创伤性颅脑损伤患者的血糖、CRP和血清甘油三酯水平。
本文根据格拉斯哥昏迷量表比较创伤性颅脑损伤患者的血糖、CRP和血清甘油三酯水平，并评估其变化趋势。
患者分为两组（格拉斯哥昏迷量表≤8分的患者为第1组，格拉斯哥昏迷量表>8分的患者为第2组）。在入院时、入院后24小时和入院后48小时采集这些患者的血液。在入院时、入院后24小时和48小时测定血糖。在入院后24小时和48小时测定CRP和甘油三酯。比较两组之间的水平，并评估其变化趋势。
使用Excel计算上述参数的均值和标准差。使用SPSS 26软件进行统计分析。采用“t检验”和“方差分析”评估统计学意义。P值<0.05被认为具有统计学意义。
与第2组相比，第1组在24小时和48小时后血糖水平升高。与第2组相比，第1组CRP水平升高。两组甘油三酯水平无显著差异。第2组血糖水平呈下降趋势。第1组CRP呈上升趋势。两组甘油三酯水平均呈上升趋势。
第2组血糖水平下降趋势和第1组CRP水平上升趋势是由相同的发病机制引起的，这与颅脑损伤的严重程度有关。两组甘油三酯水平均呈上升趋势。由于这些参数的水平及其变化趋势与颅脑损伤的严重程度相关，定期和连续监测这些分析物可作为预后标志物。
